Self-threading suturing instrument



Nov. 8, 1960 J, E HELD SELF-THREADING SUTURING INSTRUMENT United States PatentY SELF-TI-IREADING SUTURING INSTRUMENT Joseph E. Held, New Rochelle, N.Y., assignor to Amercan Cystoscope Makers, Inc., New York, N.Y., acorporation of New York Filed Aug. 27, 1957, Ser. No. 680,465

11 Claims. (Cl. 128-340) struction and which facilitates and eases the work of the surgeon to an enhanced degree.

A more specic object of this invention is to provide such an instrument in which the working head may be freely rotated throughout 360 relative to the grip and which when positioned is completely operable and selfthreading when operated by the single hand by which it is grasped.

Patented Nov. 8

rifice the form of a sector gear or pinion which extends through a slot 24 into engagement with a portion 12a of operating rod 12 having annular lands and grooves forming a rack and extending rearwardly through the central longitudinal bore formed in housing portion 18. Operating rod 12, which is longitudinally reciprocable in housing 16 in response to rotation of trigger member 22 about its pivot pin 21, carries at its rearward end a disclike member having a greater diameter than the rod and adapted for sliding engagement with the inner wall surface of the enlarged end of housing 16. A cap member 26 threaded into the open rearward end of housing 16 serves as a retainer for the disc-like member 25 which in turn provides a shoulder or stop for the rearward end of operating spring 17. Spring 17 is normally maintained under compression and is further compressed when operating rod 12 is driven forward along cylindricalfmember 13 as trigger member 22 is rotated clockwise, as viewed in Figure 2.

j Cylindrical member 13 at its lrearward end is engirdled by a collar 27 which is fixed thereto and which is rotatably seated in the counter bore formed in housing por- Further objects as well as advantages of'the present Y invention will be apparent from the following description and the accompanying drawings in which Figure 1 is a top plan view of a self-threading suturing instrument constructed in 'accordance with the present invention;

Figure 2 is a side elevational view thereof partially in section;

Figure 3 is a sectional view of the needle end of the instrument showing the needle in its fully actuated p0- sition;

Figure 4 is a plan view, partially in section taken from the point of View of the line 4-4 of Figure 3 in the direction indicated; and

Figures 5 and 6 are cross-sectional views taken respectively through the lines 5-5 and 6 6 of Figure 2.

'Referring now to the drawings in detail, self-threading suturing instrument 10 comprises a grip portion 11 connected by means of an operating rod 12 and cylindrical tubular member 13 to a suturing needle 14 mounted at the distal end of the latter.

Grip portion 11 is in the form of a pistol grip having a handle or grip 15 extending at an oblique angle with respect to housing 16 to which it is joined. Member 15a, fixed to grip 15 intermediate the ends thereof functions as a stop or rest to properly position the hand of the user and prevents slipping of the hand laterally along the grip when the instrument is in use. The rearward or proximal portion of housing 16 is of somewhat enlarged diameter and houses operating spring 17 while a reduced diameter portion 18 thereof provides Aa y tion 18. -An annular groove 28, in which a retainer 29 is slidably seated, extends entirely about the radially outer surface of collar 27. Screw 30, extending through the wall of housing portion 18, is threaded into retainer 29 and together therewith prevents longitudinal displacement of collar 27 and tubular member 12 while permitting free rotationl thereof relative to the housing and grip. vThe external portion of collar 27 is conveniently formed as an enlarged diameter ring the surface 31 of which is knurled to facilitate manual rotation of member13.

Needle 14 is of arcuate configuration and has an elongated shank portion 35 provided with a longitudinali slot 36 which, adjacent to one end thereof, opens laterally through an opening 37. An aperture 38 is provided adjacent to the end of the shank in which a pivot pin extends as will be described.

Needle 14 is pivotally connected to the forward or distal end of tubular member 13 with its shank portion 35 extending through a longitudinal slot 39 formed in the forward end portion of operating rod 12. An operating pin 40 has a diameter such as to provide a running fit in slot 36, formed in the needle shank, and extends therethrough as well as across slot 39, being connected at its opposite ends to rod 12. A mounting block 41, connected to the underside (as viewed in Figure 3) of tubular member 13 has a vertical slot 42 formed therein which is in registration with a slot 43 formed'in tubular member 13. Slots 42 and 43 are also in registration with slot 39. An arm 44, hingedly mounted in a second slot 45, formed in block 41 transversely to and opening into sl-ot 42, carries a pin 46 which, with arm 44 in its closed position, as shown most clearly in Figure 5i extends through aperture 38 in needle 14 and across slot 42 to seat in the opposite side of mounting block 41, thereby providing the aforementioned pivot for the needle.

With the parts as thus far described, forward motion of operating rod 12 is transmitted, through operating pin 40, to needle 14 which is thereby caused to rotate clockwise as viewed in Figure 2 to the positionrshown in mounting post 4 9 which is threaded into operating'rd 12. An elongated threading member` 50 is pivotallycil nected at one end thereof to post 49 by means of pin 51 while its remaining end is left free. A H-shaped hinge member 52 is pivotally connected at one end thereof to tubular member 13 while its opposite end is pivotally connected, as indicated at 53, to threading member 50. The free, forward end of threading member 50 is bifurcated to provide a pair of spaced arms 50a and 50b, the free ends of which are arcuate so that they extend somewhat in the direction away from tubular member 13. A resilient clip member 54 is connected at one end thereof to the surface of threading arm 50 presented toward tubular member 13. The opposite or free end of clip member 54 is bifurcated to form a pair of spacedarms 54a and 54b each of which registers respectively with one of the arms 50a and 50b of the threading member. The free ends of the clip member arms 54a and 5412 are curved in the opposite direction than the corresponding ends of arms 50a and 50]? as most clearly shown in Figures 2 and 3 to provide a thread receiving notch 55 therebetween. Adjacent to its free end each of the clip member arms 54a and 54b carries a tab 56 which together serve to limit rearward movement of the thread when it is engaged in the thread receiving notch 55 as will be more fully pointed out.

A supply of thread 57 is carried on a bobbin 59 rotatably mounted in a housing 60. The thread is drawn from the bobbin through an opening 61 in housing 60 against the pressure of resilient clip 62 mounted on the housing 60. After the thread is seated in notch 55 the free end thereof is engaged behind a second clip 63 provided 0n housing 60 for that purpose.

As most clearly shown in Figures 2, 3 and 4, forward motion of operating rod 12, upon clockwise rotation of trigger 22, carries mounting post 49 and threading member 50 forward. At the same time H-shaped hinge member 52 pivots about its end which is connected to tubular member 13. The forward travel of the threading arm is such that hinge member 52 swings through and beyond the position in which it extends perpendicular to the axis of the operating rod 12. At the same time, forward motion of operating rod 12 causes rotation of needle 14 as has been pointed out. The relationship of the parts islsuch that the tip or working end of needle 14 enters the slot at the bifurcated ends of the threading member 50 and clip member 54 just before hinge member 52 reaches the position in which it is perpendicular to the axes of tubular member 13 and operating rod 12. As the forward motion of the operating rod continues the thread receiving notch S continues to move away from the needle so that the tip of the latter clears the thread 57 resting in notch 55. The final motion of the operating rod carries the threading arm sufficiently forward so that hinge member 52 on passing through its perpendicular position carries the threading member back vtowards needle 14 and the thread is seated in a notch 58 on the outer periphery of the needle.

Now, when trigger 22 is released, operating rod 12 travels rearwardly under the influence of expanding operating springs 17. Needle 14 is rotated counterclockwise to the position shown in Figure`2 and carries thread 57 with it. Simultaneously, the threading member 50 is shifted from its erected position as shown in Figure 3 to the position shown in Figure 2.

It will be readily appreciated that when the instrument is used for suturing that apart from inserting the thread into the notch 55 at the end of the threading member and clip it is only necessary for the surgeon to pass the point of the needle through the parts to be joined by the suture and then to pull and release trigger 22 to carry out the insertion of the thread at the site where the suture is to be made. The thread is then cut and tied. Thread 57 is withdrawn from bobbin 59 to a sucient extent to permit a fresh length of the thread to be engaged in the notch 55 in preparation for the formation of the next suture, vIn addition to lbeing self-threading and operable by the single hand in which it is grasped, sutures may be effected having any orientation around a full 360 while the surgeons hand which grasps the instrument rnay be maintained in its most efficient working position.

The terms and expressions which have been employed are used as terms of description and not of limitation, and there is no intention, in the use of such terms and expressions of excluding any equivalents of thek features shown and described or portions thereof, but it is recognized that various modications are possible within the scope of the invention claimed.

I claim:

1. A surgical suturing instrument, comprising an arcuate needle having a sharpened end portion and a notch formed in the surface thereof adjacent tosaid sharpened end portion, means supporting said needle for rotational motion along a predetermined path, threading means for automatically threading said needle by seating a suture in said notch and including a threading member having a portion thereof adapted to carry releasably a suture, said threading member being mounted for movement along a path which intersects the path traced by said end portion of said needle, means for simultaneously advancing said needle and said threading member along their respective paths and thereby bring said portion of said threading member into juxtaposition with said end p0rtion of said needle with the suture carried by said threading member in position to be engaged in said notch and for simultaneously withdrawing said needle and said threading member along their respective paths with the suture engaged in said notch and thereby carried by said needle.

2. A surgical suturing instrument, comprising an arcuate needle having a sharpened end portion and a notch formed in the surface thereof adjacent to said sharpened end portion, means supporting said needle for rotational motion along a predetermined path, threading means for automatically threading said needle by seating a suture in said notch, said threading means having a slot formed therein and being adapted to releasably carry a suture with the latter extending across said slot, said threading means being mounted for movement along a path which intersects the path traced by said end portion of said needle, means for simultaneously advancing said needle and said threading means along their respective paths and thereby bring said portion of said threading means into juxtaposition with said end portion of said needle with said needle extending in said slot and with said notch in position to engage said suture and for simultaneously withdrawing said needle and said threading means along their respective paths with the suture engaged in said notch and thereby carried by said needle.

3. A surgical suturing instrument, comprising a handle adapted to be manually grasped, elongated support means connecting to said handle, an arcuate needle having a sharpened end portion and a notch formed in the surface thereof adjacent to said sharpened end portion, said needle being rotatably connected to said support means with said end portion being movable along a predetermined path, threading means for automatically threading said needle by seating a suture in said notch and including a threading member having a portion thereof adapted to releasably carry a suture, said threading member being movably connected to said support means and movable along a path which intersects the path traced by said end portion of said needle, operating means connected to said needle and threading means and movable relative to said support means in one direction for simultaneously advancing said needle and said threading member along their respective paths and thereby bring said portion of said threading member into juxtaposition with said end portion of said needle with the suture carried by said threading member in position to be engaged in said notch, said operating means being adapted to simultaneously Withdraw said needle and said threading member along their respective paths with the suture engaged in said lnotch and thereby carried by said needle.

4. A surgical suturing instrument, comprising a handlev Iend portion and a notch formed in the surface lthereof adjacent to said sharpened end portion, said needle being rotatably connected to said support means for rotation 'about an axis perpendicular to said support means axis and with said end portion being movable along a predetermined path, threading means for automatically threading said needle by seating a suture in said notch and including a threading member having a portion thereof adapted to releasably carry a suture, said threading member being movably connected to said support means and movable along a path which intersects the path traced by said end portion of said needle, operating means including an operating member rotatable with said support means and connected to said needle and threading means and movable relative to said support means in one direction for advancing said needle and said threading member along their respective paths and thereby bring said portion of said threading member into juxtaposition with said end portion of said needle with the suture carried by said threading member in position to be engaged in said notch, said operating means being adapted to withdraw said needle and said threading member along their respective paths with the suture engaged in said notch and thereby carried by said needle.

5. A surgical suturing instrument, comprising a handle adapted to be manually grasped, elongated support means rotatably connected to said handle for rotation about its longitudinal axis, an arcuate needle having a sharpened end portion and a notch formed in the surface thereof adjacent to said sharpened end portion, said needle being rotatably connected to said support means for rotation about an axis perpendicular to said support means axis and with said end portion being movable along a predetermined path, threading means for automatically threading said needle by seating a suture in said notch and including a threading member having a portion thereof adapted to releasably carry a suture, said threading member being movably connected to said support means and movable along a path which intersects the path traced by saidend portion of said needle, operating means including an operating member rotatable with said support means and connected to said needle and threading means and movable relative to said support means in lone direction forvsimultaneously advancing said needle and said threading member along their respective paths and thereby-bring said portion of said threading member into juxtaposition with said end portion of said needle with the suture carried by said threading member in position to'be engaged in said notch, said operating means being adapted to simultaneously withdraw said needle and said threading member along their respective paths with the suture engaged in said notch and thereby carried by said needle.

6. A surgical suturing instrument, comprising a handle adapted to be manually grasped, a tubular support member connected to said handle, an arcuate needle having a sharpened end portion and a notch formed in the surface thereof adjacent to said sharpened end portion, said needle being rotatably connected to said support means for rotation about an axis perpendicular to said support means axis and with said end portion being movable along a predetermined path, threading means for automatically threading said needle by seating a suture in said notch and including a threading member having a portion thereof adapted to releasably carry a suture, said threading member being movably connected to lsaid support member and movable along a path which intersects the path traced by said end portion of said needle, operating means including an operating member extending along said support` member and connected to said needle vand threading means, saidoperating member being ymovable relative to said supporting member in one direction foradvancing said needle and said threading member along their respective paths and thereby bring said portion of said threading member into juxtaposition with said end portion of said needle with the suture carried by said threading member in position to be engaged in said vnotch and said operating means being adapted to withdraw said needle and said threading member along their respective paths with the suture engaged in said notch and thereby carried by said needle. v

7. A surgical suturing instrument, comprising a handle adapted to be manually grasped, an elongated tubular support member rotatably connected to said handle for rotation about its longitudinal axis, an arcuate needle having a sharpened end portion and a notch formed in the surface thereof adjacent to said sharpened end portion, said needle being rotatably connected to said support member for rotation about an axis perpendicular to said support member axis and with said end portion being movable along a predetermined path, threading means for automatically threading said needle by seating a suture in said'notch and including a threading arm having a portion thereof adapted to releasably carry a suture, said threading arm being movably connected to said support member and movable along a path which intersectstthe path traced by said end portion of said needle, operating means including an elongated operating member extending along said support member and connected to said needle and threading means, said operating member being rotatable with said support member and movable longi tudinally relative to said support member in one direction for advancing said needle and said threading arm along their respective paths and thereby bring said portion of said threading arm into juxtaposition with said end portion of said needle with the suture carried by said threading arm in position to be engaged in said notch, and said operating means being adapted to withdraw said needle and said threading member along their respective paths with the suture engaged in said notch and thereby carried by said needle.

8. A surgical suturing instrument, comprising a handle adapted to be manually grasped, an elongated tubular support member rotatably connected to said handle for rotation about its longitudinal axis, an arcuate needle having a sharpened end portion and a notch formed in the surface thereof adjacent to said sharpened end portion,- said needle being rotatably connected to said support member for rotation about an axis perpendicular to said support member axis and said end portion being movable along a predetermined path, threading means for automatically threading said needle by seating a suture in said notch and including a threading arm having a portion thereof adapted to releasably carry a suture, said threading arm being movably connected to said support member and movable along a path which intersects the path traced by said end portion of said needle, said needle having an elongated slot formed therein, operating means including an elongated operating member extending longitudinally within said support member, means connecting said operating member to said needle and said threading arm with said operating member movable along said slot, said operating member being rotatable with said support member and movable longitudinally relative to said support member in one direction for advancing said needle and said threading arm along their respective paths and thereby bring said portion of said threading arm into juxtaposition with said end portion of said needle with the suture carried by said threading arm in position to be engaged in said notch, and said operating means being adapted to withdraw said needle and said threading member along their respective paths with the suture engaged in said notch and thereby carried by said needle.

9. A surgical suturing instrument, comprising a handle adapted to be manually grasped, an elongated tubular support member connected to said handle, an arcuate needle having a sharpened end portion and a notch formed in the surface'thereof adjacent to said sharpened end portion, said needle being rotatably connected to said support member for movement along a predetermined path, threading means for automatically threading said needle by seating a suture in said notch, said threading means having a slot formed therein and being adapted to releasably carry a suture with the latter extending across said slot, said threading means being movably connected to said support member and movable along a path which intersectstthe path traced by said end portion of said needle, said needle having an elongated slot formed therein, operating means extending along said support member and connected to said needle and said threading means with said operating means movable along said slot, said operating means being movable relative to said support member in one direction for advancing said needle and said threading Vmeans along their respective paths and thereby bring said portion of said threading means into juxtaposition with said end portion of said needle with said needle extending in the threading means slot and with said notch in position to engage said suture, and said operating means being adapted to Withdraw said needle and said threading member along their respective paths with the suture engaged in said notch and thereby carried by said needle.

10. A surgical suturing instrument, comprising a handle adapted to be manually grasped, an elongated tubular support member rotatably connected to said handle for rotation about its longitudinal axis, an arcuate needle having a sharpened end portion and a notch formed in `thesurface thereof adjacent tosaid sharpened end por tion, said needle being rotatably connected to said support member for rotation about an axis perpendicular to said support member axis and said end portion being movable along a predetermined path, threading means for automatically threading said needle by seating a suture in said notch, said threading means having a slot formed therein and being adapted to releasably carry a suture with the latter extending across said slot, said threading means being movably connected to said support member and movable along a path which intersects the path traced -by said end portion of said needle, said needle having an elongated slot formed therein, operating means extending longitudinally within said support member and connected to said needle and said threading member with said operating means movable along said slot, said operatingmeans being rotatable with said support member and movable longitudinally relative to said support member in one direction for advancing said needle and said threading means along their respective paths and thereby bring said portion of said threading means into juxtaposition with said end portion of said needle with said needle extending in the threading means slot and with said notch in positionl to engage said suture, and said operating means being adapted to withdraw said needle and said threading member along their-respective paths withthe suture engaged in said notch :and thereby carried by said needle.

11. A surgical suturing instrument, comprising 'a handle adapted to be manually grasped, an elongated tubular support member having a longitudinal slot formed therein adjacent to one end thereof and rotatably connected ad-A jacent to the other end thereof to said handle for rotation about its longitudinal axis, an arcuate needle havinga sharpened end portion and a notch formedin the sur-l face thereof adjacent to said sharpened end port-ion, said needle extending in said slot and being rotatably connected to said support member for rotation along said slot about an axis perpendicular to said support member axis with said end portion being movable alonga predetermined path, said support member having a second slot formed through one side thereof in registration with said elongated slot, an elongated operating member extending longitudinally within said support member and connected adjacent to one end thereof to said needle, an elongated threading arm bifurcated at one end thereof and pivotally connected adjacent to the other end thereof to said operating member through said second slot, a resilient bifurcated clip member connected to and carried by said threading arm and forming therewith a slot extending in alignment With said needle, said threading arm and clip member forming a suture receiving notch extending on opposite sides of said last mentioned slot, a hinge member pivotally connecting said threading arm intermediate the ends thereof to said support member, Y'the bifurcated portion of said threading arm being movable along a path which intersects the path traced by said end portion of said needle, said operating member being rotatable with said support member and movable longitudinally relative to said support member in one direction for advancing said needle and said threading arm along their respective paths and thereby bring said portion of said threading arm into juxtaposition With said end por-l tion of said needle with the suture carried by said thread- ,ing arm .in position to be engaged in said notch, resilient means normally urging said operating member in the direction to withdraw said needle and said threading member along their respective paths, and means connected to said handle for moving said operating member in said one direction.

References Cited in the file of this patent UNITED STATES PATENTS 1,635,066 'Wens July 5, 1927 2,286,578 Sauter Iunel6, 1942 2,704,526 kBenink et al Mar. 22, 1955 

